Sometimes an illness appears in the human body for no apparent reason, which is associated with uncontrolled self-reproduction of cells. One of the varieties of such ailments is nail melanoma. The initial stage of the disease is not very noticeable and may resemble other destructive processes. Therefore, patients seek help at a later stage.
Features of the disease
In simple terms, nail melanoma is a type of cancerous tumor that is characterized by aggressive development and a specifically pronounced clinical picture. If we take all oncological diseases, then about 4 percent are accounted for by this disease.
Medical statistics show that in most cases the thumb on the right hand is affected. The preliminary stage of the oncological process is hidden. It is not always possible to detect cancer by external parameters.
Most often, nail melanoma is stained with epithelial pigment. In this case, it becomes much easier to establish the correct diagnosis even with a preliminary examination by a doctor. Approximately 20% of malignant tumors do not havesuch a color that complicates the diagnosis.
Reasons for appearance
Different factors can lead to the degeneration of the cells of the nail plate:
- presence of benign neoplasms on the skin like moles, papillomas, warts and other growths that began to form a tumor body;
- congenital malformations of the epithelium with atypical nodules present on the patient's fingers from the very beginning of life;
- oncological process in any organs or parts of the body, which led to the defeat of the nail plate by metastases;
- formation of a chancre under the nail plate resulting from a fungal or viral infection;
- Regular injury at the site of the tumor under severe physical conditions;
- exposure to the surface of the fingers of direct sunlight.
The listed risk factors can give the oncological process an initial impetus. As a result, melanoma of the nail is formed. A photo with its development in the later stages can no longer be confused with other diseases. By the appearance of the nail plate, it immediately becomes clear that there is a cancer.
Main symptoms
When oncological lesions should pay attention to a number of important points. Although it is easy to confuse the disease with a common fungal infection, there are strong signs that allow a diagnosis to be made.
Usually pay attention to the following symptoms of nail melanoma:
- Tumor formation. Often a dense to the touch outgrowth of degenerate cells is formed. It is he who begins to destroy the structure of the nail plate. Pores appear on its surface, after which the layers separate.
- Change the color of the nail. In fact, this is one of the most important signs of the course of the pathological process. The surface may turn blue, black, brown or purple. If the surface of the nail has changed color without any tangible damage, then the patient should seek help from a medical facility.
- The presence of a vertical stripe. With the growth of the tumor body, a clear vertical line often forms, dividing the surface into two parts. It most often appears in the center of the plate. The strip may change color over time. Everything will depend on the specifics of the oncological disease.
- Pus outflow from under the nail plate. In later stages, severe inflammation begins. A large amount of pus is released. The use of anti-inflammatory drugs and antibiotics in this case does not give the desired effect.
- Frequent pain at the site of the lesion. When pressed on the finger, they become pronounced. During periods of regular exacerbations, pain intensifies even in a calm state. A distinct pulsation is felt in the area of oncology.
- Detachment of the nail from the base. With the progression of the disease, the plate does not receive the necessary nutrition, so it begins to peel off from the finger. Only a soft roller remains in sight, modified by a leaking oncologicalprocess.
The presence of two or more signs leads the doctor to assume that the patient has melanoma of the toenail or handnail. Sometimes mistakes do occur, for example, a specialist who examines a patient confuses this ailment with panaritium, which belongs to the category of infectious diseases.
Types of tumors and characteristics
Melanomas can be of different types. The main types of such tumors are shown in the table:
Types of tumor of the nail plate
| Type | Characteristic |
| Shallow | Received the most distribution. With this development of events, cell changes affect the outer skin to a greater extent. The deep layers are affected only in the absence of timely treatment. |
| Lentigo | In all characteristics, the tumor is similar to the one mentioned above. It develops by affecting the same layers of the skin. Its peculiarity lies in uneven pigmentation. |
| Acreal |
Begins to appear on the surface layers of the skin, but gradually grows inside. The nail takes the form of a dark spot. Most often observed in dark-skinned people. |
| Nodal | Characterized by deep germination into the epithelial tissue. The tumor is characterized by the most aggressive nature of the lesion. |
Stages of the course of the disease
In the first two stages, melanoma under the nail is quite limited in size. Growing cells do not yet affect deep tissues and internal organs. The risk of spread is not too high.
In total, there are four main stages of the course of the disease, the main evaluation criterion of which is the thickness of the formation:
- At the first stage, the thickness of the formation is less than 1 mm. The surface of the nail has no obvious damage, ulcers are not detected. There is no pain when pressed.
- At the second stage, the thickness reaches 2-4 mm. Small ulcers appear. Often tubercles form directly on the nail plate.
- At the third stage, the thickness of the formation is 4 mm or more. Tumor cells are already reaching the regional lymph nodes, creating secondary foci there.
- At the fourth stage, it doesn't matter how thick the tumor has reached. Metastases spread to various organs. Pain is very strong. The size of the tumor grows significantly.
As for pain, they may appear already at the second stage, when the thickness of the build-up begins to reach 2-4 mm. However, this does not always happen. In some cases, pain does not occur until the very last stage, until the bone tissue of the finger begins to be completely affected.
Basic diagnostic options
It is important at the right time to accurately determine that nail melanoma has appeared. The initial phase of the development of the disease is treated much easier than the late one. To identifydangerous disease, special diagnostic measures are used:
- general study of urine and blood tests;
- MRI;
- tissue biopsy;
- transillumination of the nail plate with a special device;
- implementation of ultrasound examination;
- determining the presence of oncological markers;
- receiving a puncture from the lymph nodes.
The listed options allow you to get certain information, but they are usually carried out in combination. After studying the results, a concrete conclusion is made.
Treatment process
Before starting the treatment of nail melanoma, the presence of metastases is determined. At the initial stages, the patient is removed the neoplasm that has appeared surgically. If necessary, he althy tissues located around the affected area are also affected. The phalanx is cut off only in advanced cases.
When metastasis is formed, the effectiveness of treatment decreases dramatically. The patient may additionally be prescribed radiation or chemical therapy. Sometimes lymph nodes need to be removed.
Survival forecast
When evaluating the prospects for treatment of nail melanoma, the stage of detection of the disease plays an important role. Even if the patient has recovered, it is necessary to monitor the state of he alth all the time. There is a high risk of recurrence of the disease. Sometimes, even after a few years, the disease returns.
Five-year survival rate in the presence of a tumor as a percentage is expressedas follows:
- At the first stage - 95%.
- At the second stage - 70%.
- At the third stage - 30%.
- At the fourth stage - 7%.
Low survival in the last stages is due to the appearance of metastases, which can occur not only in the affected fingers, but also in other parts of the body.
Final part
To avoid complex and long-term treatment for nail melanoma, it is necessary to adhere to preventive measures. You should limit exposure to direct sunlight, as well as avoid bad habits such as drinking alcohol and smoking tobacco products. In case of suspicious changes in the nail plate, you should immediately consult a doctor.
